None listed
Conditions
Brief summary
Alcohol and other drug use is a leading cause of harm for Aboriginal and Torres Strait Islander youth. Despite resilience and a continuous strong connection to culture, the ongoing impacts of colonisation, disempowerment, and inequity have an intergenerational impact on the wellbeing of Aboriginal and Torres Strait Islander adolescents. This intergenerational impact contributes to average initiation of substance use two to six years earlier among Aboriginal and Torres Strait Islander compared to non-Indigenous adolescents. Prevention of youth alcohol and drug use has therefore been identified as a key priority for improving the wellbeing and addressing health inequities between Aboriginal and non-Indigenous Australians. Previous research has found that curriculum programs implemented in secondary school can effectively prevent uptake of these substances by young people, and have flow-on benefits for social and emotional wellbeing, physical health, school attendance, and educational attainment. However, there are currently no school-based drug prevention programs that are culturally-inclusive and effective for Aboriginal and/or Torres Strait Islander students. To address this gap we partnered over the past three years with Gilimbaa, an Indigenous Creative Agency, and four schools in QLD and NSW to develop Strong & Deadly Futures, a cultural adaptation of the effective Climate Schools school-based prevention program. The program was co-developed with school staff and Aboriginal and/or Torres Strait Islander youth, who shared their stories, role models, things they love about their community and positive reasons for not using alcohol and other drugs. These perspectives formed the basis of the story arc for an illustrated story, which communicates the key prevention messages and highlights Aboriginal and/or Torres Strait Islander cultural strengths. The current trial builds on a successful pilot study in four schools, and will be the first RCT of a school-based, culturally-inclusive drug and alcohol program for young Aboriginal and/or Torres Strait Islander peoples. Strong & Deadly Futures will recruit 960 Year 7 and/or 8 students from 24 schools across Australia during 2022. Hypothesised benefits include reduced drug and alcohol use, and improved wellbeing.
Interventions
Strong & Deadly Futures is a culturally inclusive school-based alcohol and other drug use prevention program that features computerised delivery to enhance engagement, reach and sustainability. The program incorporates core skill development and harm minimisation components from the effective "Climate Schools" school-based prevention program, and has been adapted in collaboration with Aboriginal and Torres Strait Islander stakeholders to be culturally inclusive and highlight Aboriginal and Torre
Strong & Deadly Futures is a culturally inclusive school-based alcohol and other drug use prevention program that features computerised delivery to enhance engagement, reach and sustainability. The program incorporates core skill development and harm minimisation components from the effective "Climate Schools" school-based prevention program, and has been adapted in collaboration with Aboriginal and Torres Strait Islander stakeholders to be culturally inclusive and highlight Aboriginal and Torres Strait Islander cultural strengths. The program aligns with the Australian Health and Physical Education curriculum and is designed to be delivered in Year 7/8 health education classes. The program consists of six lessons, which take approximately 45-60 minutes each to complete, and are optimally delivered once a week for six weeks. The 6 lessons cover the content: 1. Coping with psychological distress 2. Alcohol education: short term consequences and harm minimisation 3. Alcohol and tobacco education: normative messaging, role models, helping a friend, finding information about alcohol and other drugs 4. Alcohol and tobacco education: Alcohol and other drug refusal strategies, peer pressure and alternatives to using alcohol and other drugs 5. Cannabis: Long term consequences of alcohol and other drug use, coping with other people’s alcohol and other drug use 6. Alternatives to alcohol and other drug use Students and teachers access the program content by creating accounts on the website www.strongdeadly.org.au. Each lesson includes 10-minutes of computerised, illustrated stories covering key learning outcomes and 20-40 minutes of classroom activities for the teacher to deliver. Student accounts provide access to the illustrated stories and student lesson summaries. Teacher accounts provide access to the stories, teacher summaries, and a selection of class activity options (e.g. pre-specified worksheets, discussion topics and activities). Teachers are able to choose from a range of approximately six activity options for each lesson, one of which focuses on Aboriginal and Torres Strait Islander cultural identity and strengths. Six months after the six lessons, two booster sessions are delivered to help students refresh the content. Booster sessions are delivered a week apart, and follow the same structure as the original program. Teachers are primarily responsible for implementing Strong & Deadly Futures. To assess implementation fidelity, teachers will record lesson procedures and activities on an online logbook accessed via their Strong & Deadly Futures website account. A local Aboriginal and/or Torres Strait Islander facilitator will be employed to assist teachers in each school, particularly to support classroom activities related to cultural strengths. The facilitators will also assist with survey administration, measurement of implementation fidelity through lesson observations. All local facilitators will receive research training and regular supervision and mentoring from the research team. Students will complete surveys at pre- and post-intervention, and at 12- and 24-months follow-up to assess intervention effects. Facilitation Training Facilitators will attend a series of workshops with the research team to support the pre-trial community consultation phase and RCT implementation. Facilitators will attend three 1-hour online workshops before the community consultation sessions to explain the research process, purpose and procedure of the consultation phase. These will take place in the month before community consultation sessions commence; anticipated to occur between October 2021 and April 2022. Facilitators will also be provided access to the Strong & Deadly Futures program materials to familiarise themselves with the program content. Facilitators will attend workshops before the trial implementation phase, anticipated to be in approximately May-June 2022. For the Strong & Deadly Futures group, there will be two 1-hour online workshops with the research team to discuss program implementation, survey administration and troubleshoot any technical issues. Teachers will be provided with online access to the Strong & Deadly Futures website to familiarise themselves with the program content and materials. For the waitlist control group, there will be one 1-hour online workshop with the research team to discuss aspects related to survey administration, and to troubleshoot technical issues relating to survey access. A handbook will be developed for facilitators covering all workshop content, materials (i.e. consultation protocols, surveys), and frequently asked questions. The handbook materials for the consultation phase will be provided to facilitators in advance of the consultation workshops, and materials for the trial phase provided in advance of the trial workshops
Sponsors
The University of Sydney
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
11 Years to 15 Years
Healthy volunteers
Yes
Inclusion criteria
• Year 7 and/or 8 students attending participating schools in 2022 • Fluent in English • Active student consent provided • Passive parental consent to participate (QLD Independent schools and NSW public schools) or active parental consent to participate (QLD public and WA independent schools; differing protocols due to varying ethics committee requirements).
Exclusion criteria
- Schools with fewer than 12 Aboriginal and/or Torres Strait Islander students in Year 7 and/or 8 in 2022 - Schools based outside NSW, WA, and QLD
Outcome results
None listed